| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $194.98 | $208.93 | $245.47 | |
Hally Health
| Professional | $100.00 | $199.53 | $346.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $87.10 | $104.71 | $177.83 | |
United
| Professional | $74.13 | $97.72 | $112.20 |